Questionnaires for the assessment of bleeding symptoms

Dr Alfonso Iorio is a professor in the Division of Hematology and Thromboembolism, Division of General Internal Medicine, and Department of Health Research Methods, Evidence, and Impact at McMaster University.

Do you use any questionnaires to assess bleeding symptoms?

Alfonso Iorio, MD, PhD: I do not personally, and the reason is that I work in a referral center. When patients are sent to us, they usually have enough bleeding manifestations, so you do not need to use a questionnaire.

Questionnaires are very useful at the first-level screening—at a family physician level or general internal medicine approach—where it is important not to forget anything. If I can recommend one, I would suggest the self-administered bleeding tool (Self-BAT). It was published, I think, in 2015 by Paula James group in Kingston and it is a reduced version of the International Society on Thrombosis and Haemostasis (ISTH) screening tool that was set up by Alberto Tosetto in Vicenza.

It was calibrated for diagnosis of von Willebrand disease but it also works very well for platelet disorders and is a very effective screening test. If your score is 3 or more, the chance of having a bleeding disorder is higher than 10%; if instead your score is 1, 0, or less, it is almost impossible. It is a very effective, very rational approach to screening.